Saturday, May 23, 2020

Basketball: Gatekeeping, No One Knows What Goes on Behind Closed Doors



Investopedia defines "GATEKEEPERS as people or policies that act as a go-between, controlling access from one point to another. They may refuse, control, or delay access to services. Alternatively, they may also be used to oversee how work is being done and whether it meets certain standards."

 Gatekeepers ascertain the best version of the truth for the good of both individuals and society. Many professionals have "gatekeeper" roles. The physician is part of the ancillary staff keeping a team running. 

 Physicians constantly decide a patient's status. How did that apply in the Navy?
  • Is a volunteer healthy enough for service? For example, asthma after age thirteen is disqualifying. 
  • Is a trainee physically or mentally incapable of undergoing recruit training after already accepted into the service? 
  • Can a (mildly) sick sailor return to work and in what capacity? You wouldn't want someone with terrible eczema working in a severely unhygienic area. 
  • Will an illness require a service member to be medically placed on the long-term "disabled list" (medical board, e.g. six months limited duty)?  
  • Will an active duty member be separated (pilots avoid doctors like the plague)? 
  • Is a previous illness disqualifying for a major promotion? Some older readers remember that Missouri Senator Thomas Eagleton was briefly the Democratic nominee for Vice President. A diagnosis of recurrent depression led to him being dropped from the McGovern ticket. Society becomes the gatekeeper.
It's not always black and white, but the Manual of the Medical Department provides guidance. But the physician has to decide not what is first in the interest of the patient, but in the interest of the Navy. Imagine a firefighter who develops asthma. The asthma, worse under extreme conditions, respiratory protection, and heavy gear impairs the firefighter, his peers, and the community. The "mildest" asthma could produce fatalities under stress. He can have a family or golf, but is disabled for his military job. 

 We can even be our own gatekeeper. A Navy surgeon went to Fort Leavenworth after court-martial for not declaring a vision problem. 

 Can a player play with spinal deformity, after a "stinger" or transient quadriplegia? When can a player return to play after a concussion, surgery, a collapsed lung? More than one gatekeeper is often involved as specialty consultation is often required. 

 Does an exposure need quarantine? Someone was jogging past a playground where some children were found to have COVID-19. What do you say? Can a COVID-19 patient return to work? Is there a fixed time period, time plus symptom-free period, or do they need a negative test? 

 Coaches are gatekeepers. They break barriers or provide access for players. Dean Smith's recruitment of Charles Scott broke a barrier. Bill Russell's ascension to Celtics' player-coach changed the coaching world. Could a woman someday play in the NHL, most likely as a goalie? 

 Coaches are asked about a player's makeup - work ethic, focus, resilience. Is she a good teammate? We get asked about physical and mental toughness and leadership qualities. College coaches don't want to assume new headaches, immature players, and referee baiters. Few coaches want to stake their reputations recommending "bad risk" or "bad fit" players. I favor the saying, "the best predictor of future behavior is past behavior." 

Lagniappe:  David Blatt "Horns, DHO, PnR"

Horns offers a myriad of possibilities. 

 Lagniappe 2: "High off the glass"
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